Background: This study aimed to propose a classification of acetabular defects in advanced-stage hip tuberculosis based on preoperative radiographs and intraoperative evaluation, thereby providing options for reconstructing each type of defect in hip arthroplasty. Materials and Methods: We conducted a prospective study with 45 patients with active hip tuberculosis at stage IV who were treated with a total hip replacement strategy. We collected the patients' acetabular defect data from preoperative radiographs and intraoperative observations. The defects were classified into types based on defect severity and reconstructive complexity. The hip replacement outcomes were evaluated at least 12 months after the operation. Results: The classification system includes three types: type I: localized or extensive defects inside the acetabulum, not affecting the acetabular rim, medial wall, or columns. Type II: extensive defects inside the acetabulum, affecting the acetabular rim or (and) medial wall. Type III: extensive defects inside the acetabulum, causing the medial wall and the acetabular column to lose function. Each type has a corresponding reconstruction. The outcome includes that 41/45 patients had excellent results; 3/45 patients had good results. The patients had good results due to nerve and muscle damage caused by tuberculosis not related to the acetabular defects. Conclusion: This is a simple, practical classification system of acetabular defects in hip tuberculosis. The outcome of hip reconstruction using this classification was excellent without any cases of dislocation or protrusion.
Background and objective Tuberculosis (TB) of the hip refers to the hip infection caused by tubercle bacilli. Treatment for hip TB includes anti-TB medications, surgery to remove joint abscesses, and orthopedic surgery. It is necessary to conduct tests to confirm that the tubercle bacilli have been eradicated following the treatments. In this study, we aimed to assess the change in hemoglobin and C-reactive protein (CRP) serum levels in patients with hip TB before and two months after receiving specific treatments. We sought to determine whether they are significant tests for the treatment prognosis of hip TB. Methods We employed a prospective cohort design for this study. It was conducted at National Lung Hospital, Hanoi, and involved 24 hip TB patients with intra-articular abscesses who were treated at the center during the period from October 2016 to October 2021. Blood hemoglobin, CRP serum level, and abscesses on hip MRI were assessed before and two months after treatments. Hemoglobin was examined by spectrophotometry, and CRP serum was measured using the immunoturbidimetric method. Results Before treatments, the average hemoglobin level in the patients was 11.48 ± 1.85 g/dl; the average CRP serum level was 63.53 ± 36.47 mg/l. After two months of treatments, the average hemoglobin level increased significantly to 13.22 ± 1.36 g/dl, while the average CRP level reduced significantly to 12.55 ± 11.34 mg/l. However, five cases displayed abnormal findings. These five individuals continued to have intra-articular abscesses. Conclusion In individuals who reacted well to the therapy, blood hemoglobin and CRP serum levels improved. Blood hemoglobin and serum CRP assays can be utilized to monitor outcomes in hip TB therapy.
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